Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.
Division of Cardiology, The Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Cardiovasc Diabetol. 2021 Dec 28;20(1):242. doi: 10.1186/s12933-021-01433-0.
Elevated blood pressure among adolescents has been shown to be associated with future adverse cardiovascular outcomes and early onset diabetes. Most data regarding systolic and diastolic blood pressure trends are based on surveys of selected populations within 10-20-year periods. The goal of this study was to characterize the secular trend of blood pressure given the rising prevalence of adolescent obesity.
This nationwide population-based study included 2,785,515 Israeli adolescents (41.6% females, mean age 17.4 years) who were medically evaluated and whose weight, height and blood pressure were measured, prior to mandatory military service between 1977 and 2020. The study period was divided into 5-year intervals. Linear regression models were used to describe the P for trend along the time intervals. Analysis of covariance was used to calculate means of blood pressure adjusted for body mass index.
During the study period, the mean body mass index increased by 2.1 and 1.6 kg/m in males and females, respectively (P for trend < 0.001 in both sexes). The mean diastolic blood pressure decreased by 3.6 mmHg in males and by 2.9 mmHg in females (P < 0.001 in both sexes). The mean systolic blood pressure increased by 1.6 mmHg in males and decreased by 1.9 mmHg in females. These trends were also consistent when blood pressure values were adjusted to body mass index.
Despite the increase in body mass index over the last four decades, diastolic blood pressure decreased in both sexes while systolic blood pressure increased slightly in males and decreased in females.
青少年血压升高与未来心血管不良结局和糖尿病发病年龄提前有关。大多数关于收缩压和舒张压趋势的数据都是基于对 10-20 年内特定人群的调查。本研究的目的是描述血压的季节性趋势，因为青少年肥胖的患病率正在上升。
这项全国性的基于人群的研究纳入了 2785515 名以色列青少年（41.6%为女性，平均年龄 17.4 岁），他们在 1977 年至 2020 年期间在强制兵役前接受了医疗评估，测量了体重、身高和血压。研究期间分为 5 年间隔。线性回归模型用于描述时间间隔的 P 趋势。协方差分析用于计算调整体重指数后的血压平均值。
在研究期间，男性和女性的平均体重指数分别增加了 2.1 和 1.6 kg/m2（两性均 P < 0.001）。男性舒张压平均下降 3.6 mmHg，女性下降 2.9 mmHg（两性均 P < 0.001）。男性收缩压平均升高 1.6 mmHg，女性收缩压平均降低 1.9 mmHg。当血压值调整到体重指数时，这些趋势仍然一致。
尽管过去四十年体重指数有所增加，但男女的舒张压均有所下降，而男性的收缩压略有升高，女性的收缩压则有所下降。
